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经皮肝灌注治疗葡萄膜黑色素瘤肝转移患者的生活质量分析。

Quality of Life Analysis of Patients Treated with Percutaneous Hepatic Perfusion for Uveal Melanoma Liver Metastases.

机构信息

Interventional Radiology Research (IR2) Group, Department of Radiology, C2-S, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.

Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands.

出版信息

Cardiovasc Intervent Radiol. 2024 Jun;47(6):741-750. doi: 10.1007/s00270-024-03713-0. Epub 2024 Apr 8.

Abstract

PURPOSE

Percutaneous hepatic perfusion with melphalan (M-PHP) is a minimally invasive therapy with proven efficacy in patients with uveal melanoma (UM) liver metastases. M-PHP is associated with a short hospital admission time and limited systemic side effects. In this study, we assessed quality of life (QoL) in UM patients treated with M-PHP.

MATERIALS AND METHODS

A prospective, single-center study including 24 patients treated with M-PHP for UM metastases to the liver. QoL questionnaires were collected at baseline, on day 2/3 after M-PHP, and on day 7 and day 21 after M-PHP, according to study protocol. The results were scored according to EORTC-QLQ C30 global health status (GHS), functional scales, and symptom scales. The difference in scores at baseline and subsequent time points was analyzed with the Wilcoxon signed-rank test and multiple testing Bonferroni correction. Adverse events (AE) were registered up to 30 days after M-PHP according to CTCAE v5.0.

RESULTS

Twenty-four patients (14 males; median age 63.0 years) completed 96 questionnaires. Most scores on all scales declined on day 2/3 after M-PHP. On day 21 after M-PHP, 12 out of 15 scores returned to baseline, including median GHS scores. Three variables were significantly worse on day 21 compared to baseline: fatigue (6-33; p = 0.002), physical functioning (100 vs 86.7; p = 0.003), and role functioning (100 vs 66.7; p = 0.001). Grade 3/4 AEs consisted mainly of hematological complications, such as leukopenia and thrombopenia.

CONCLUSION

M-PHP causes fatigue and a decline in physical and role functioning in the 1st weeks after treatment, but GHS returns to baseline levels within 21 days. LEVEL OF EVIDENCE 3: Cohort study.

摘要

目的

经皮肝灌注氨甲蝶呤(M-PHP)是一种微创治疗方法,已被证明对患有葡萄膜黑色素瘤(UM)肝转移的患者有效。M-PHP 具有住院时间短和全身副作用有限的特点。在这项研究中,我们评估了接受 M-PHP 治疗的 UM 患者的生活质量(QoL)。

材料和方法

这是一项前瞻性、单中心研究,共纳入 24 例接受 M-PHP 治疗 UM 肝转移的患者。根据研究方案,在基线时、M-PHP 后第 2/3 天、M-PHP 后第 7 天和第 21 天收集 QoL 问卷。结果根据 EORTC-QLQ C30 全球健康状况(GHS)、功能量表和症状量表进行评分。采用 Wilcoxon 符号秩检验和多重检验 Bonferroni 校正分析基线和后续时间点的评分差异。根据 CTCAE v5.0 登记 M-PHP 后 30 天内的不良事件(AE)。

结果

24 例患者(14 例男性;中位年龄 63.0 岁)完成了 96 份问卷。所有量表的大多数评分在 M-PHP 后第 2/3 天下降。M-PHP 后第 21 天,15 项评分中有 12 项恢复到基线,包括中位 GHS 评分。与基线相比,21 天时有 3 个变量明显恶化:疲劳(6-33;p=0.002)、身体功能(100 与 86.7;p=0.003)和角色功能(100 与 66.7;p=0.001)。3/4 级 AE 主要为血液学并发症,如白细胞减少和血小板减少。

结论

M-PHP 在治疗后 1 周内引起疲劳和身体功能及角色功能下降,但 GHS 在 21 天内恢复到基线水平。证据等级 3:队列研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f19/11164794/9b2e04671c15/270_2024_3713_Fig1_HTML.jpg

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